Suicide Watch Chronological Log Inmate Companions Log © Name of inmate on watch: = .. wv c Epsiem Shem oO 6 Zz Ss $e = Register #: 2 a eo) = 2 q Were sf 3 Bowe z — =a x5 5 £ en ¢ Institution: 4 ov % ae =-£ 2 ao 4's wi SCAHRHReE S ¢ wv oO & E S vo w oY SeTBSSSaal$ Date Watch Began/Ended 73 SBBSawES Pad 5S 5357 OG ¢ 1/23 }'4 ORAAAGAFY To be completed by Chief Psychologist at conclusion of watch: Booklet of SWCL - INMATE CONFIDENTIAL SDNY__00009534 EFTA00033867

--=PAGE_BREAK=--

STAPLE LOCAL PROCEDURES HERE Check one of the following: o This is the initial log book for this suicide watch. Enter date and time watch began: ia) This is a continuation log book for this watch. Enter date and time this watch book was initiated: Instructions to Observer: Document your observations every minutes. Legibly print and sign your name at the beginning of your shift. CONFIDENTIAL SDNY_00009535 EFTA00033868

--=PAGE_BREAK=--

Suicide Watch Observation Log Samat EBSICLA Regt: 14515. 5 | _rime | __ observations: Briefly note your observations. initial allentries. | initia _| == On | Yu Zeca vt Deer o Succi &e ceil Fi MS, — jive 8 an Cul! 4c 4 Tene Th. le Te matt 12d r(f aA __ 5b | tlm iMag om be) Lured — What Happen ——_—— A wu i (n'a 36 — rv * wa _| Ton iHyty em Bed ——— 2 Sun 7 Andi takes pictues cf ilu |B Mme | fm Gi hing yn EO AS Sted Ses fn [Ye Sey en BST pet a aS Note to all observers: Legibly print and sign your name at the beginning of your shift. SDNY_00009536 CONFIDENTIAL EFTA00033869

--=PAGE_BREAK=--

Suicide Watch ono! he OG:,! Staff Suicide Watch « “Observers Only. — . zs ‘Pogister# | | Moaecosd | “Institution: ade ei ast Date’ Watch Began | Ended . uly 23,2014 = July 2 24, oq To be completed by Chief Psychologist at conclusion of watch: _ Booklet of SWCL - STAFF CONFIDENTIAL SDNY_00009537 EFTA00033870

--=PAGE_BREAK=--

STAPLE LOCAL PROCEDURES HERE Check one of the following: ve * This is the initial log book for this suicide watch... Enter date and time watch began: Suly 23,2010 a} 40am O° Thisa continuation log book for this watch. ri Enter date and time this watch book was initiated: ope ee Hh a % \ Instructions to Observer: “3 Document your observations every AG minutes. Legibly print and sign your name at the beginning of your shift. CONFIDENTIAL SDNY_00009538 EFTA00033871

--=PAGE_BREAK=--

COSsIeIN Suicide Watch Observation Log Observations: Briefly note your observations. Initial all entries. iN thy “inmate londing at dane RY Re ee Note to all observers: Legibly print and sign your name at the beginning of your shift. CONFIDENTIAL SDNY_00009539 EFTA00033872